Provider Demographics
NPI:1205722295
Name:MULLOWNEY, ERIN KATHLEEN (DMD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHLEEN
Last Name:MULLOWNEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 BRIDGEPORT WAY STE 109
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1960
Mailing Address - Country:US
Mailing Address - Phone:757-484-1444
Mailing Address - Fax:
Practice Address - Street 1:1301 BRIDGEPORT WAY STE 109
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-1960
Practice Address - Country:US
Practice Address - Phone:757-484-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401419511122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty